HomeMy WebLinkAboutFire Alarm System Record of Completion - 02/2012 ♦ FUNDAD4EVT.�L,S OF FIRE AI.AR1�1 Sl"STE\�1S 72-33
FIRE ALARM SYSTEM RECORD OF COMPLETION
�—- - -----------7o be com��d 6y tfie�em insta7l�ion co��"actor a�"fhe time-b3sysiem acceptance and""app�ovaC-"--
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1. PROTECTED PROPERTY INFORMATION
Name of property: ������st��a� ���u-�-�tY ������ ��
Address: �g" 2t� ���So-� �7`� ���vS� (�� .�y�7 v �
Description of property:
Occupancy type: � c C�-� '
Name of property representative: L��P,f-L� /�`e ���-r
Address: ���� ��-���SO � S� �S���S� �� ��'�U �
Phone: �7.ZV -2�2 �d�Y�F Fax: �l Z� `�C�� - /� � E-mail:
Authority having jurisdiction over this property:
Phone: Fas: E-mail:
2. FIRE ALARM SYSTEM INSTALLATION, SERVICE,AND TESTING INFORMATION
Installation contractor for this equipment: �d(p� � c <`�
Address: 1 3�3 �c._c��s e� �� �S�l�'�>
Phone: ��v'23/- .� �Z'�'I� Fax: E-maiL•
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Service organization for this equipment: ./U���/'-�rY-r esS S�ct.�_!��fiy
Address: �U� � _ lCc��fl�,l- SP-. ��1..,�< � C.,.�.Z ��/ri'O Z
Phone: �1'�`Yl-G - �'r/S Z Fax: �ZU -�I"2 6 -�U?S� E-mail:�'�I���e s v I�6�ot tr.PCo r�o -Cv•k
Location of as-built drawings: Location of historical test reports
Location of system operation and maintenance manuals:
A contract for test and inspection in accordance with\TFPA standards is in effect as of _����g "�C`�
/� �
Contracted testing company: /�/ 'aJ//`Z�;Tf✓'eS�� SCcc.../.�'f/�
Address: �Oc� /�- �lo e���e1� �P�- ����5� �
Phone:c12c>-�2-� - �'z�S�2— Fax: ��``�?-�-3��� E-mail:fZi"1c�.-cs��X�rG�'cC'cv���0-C�'�-
Contract expires: Contract number: Frequency of routine inspections: ���--G ��
3. TYPE OF FIRE ALARM SYSTEM OR SERVICE
NFPA 72 Chapter Reference of System Type:
Name of organization receivina alarm sio als with phone numbers(if applicable): :
Alarm:/ �-�SD�a�� SP�c,�r.`�v �o���„�l� �2�e/ Phone:__�dC� -.��2 - � S��S
Supervisory: � � Phone: � '
Trouble: �� Phone: '�
Entity to which alarms are retransmitted: Phone:
i1�lethod of retransmission of alarms to that organization or location:
�O 2007 National Fire Protection Association NFPA 72(p.1 of 5)
FIGURE 4.52.1 Record of Completion.
COPYRIGHT 2007 NFPA,REPRODUCED WITH PERMISSION. �
2007 Edition r`F"v'e
� 72-3� NATIO\.�L.FIRE:�L..aRNi CODE �
3. TYPE OF FIRE ALARM SYSTEM OR SERVICE (continued)
-- - - ---I#'C��p�er�note the means oftransmi�sion from-t�e prot�ed premi��to t�e��ntraY�tatian:------ ----------——
�h Dib tal alarm communicator J NlcCulloh :I 1�Iultiplex ❑ 2-way radio ❑ 1-way radio ❑ N/A
If Chapter 9,note the t}�e of connection: ❑ Local enerb J Shunt jd N/A
3.1 System Software
/r, '\
Operating sy stem(executive)software revision level:i.�Cti� •C�-< ,^ U ��/ ��.
Site-specific software revision date: �,% �� Revision completed by:_,�/��
4. SIGNALlNG LINE CIRCUITS
Claaracteristics of signali.ng line circuits connected to this system(see NFPA 72, Table 6.6.1):
Quantity: � Style: "7 Class: /'�
5. ALARM-INITIATING DEVICES AND CIRCUITS
CIa¢racteristics of initiating der,�ice circuits connected to this system(see NFPA 72, Table 6.5):
Quantity: � St�-1e: Class: (s� '
5.1 Manual Initiating Devices
5.1.1 Manual Puli Stations Number of manual pull stations: �
Type of devices: J Addressable �Conventional .� Coded J Transmitter ❑ N/A
5.2 Automatic Initiating Devices
52.1 Area Smoke Detectors Number of smoke detectors: � 7
T�-pe of cocerage: �Complete area =I Partial area J i�onrequired partial area ❑ ;�T/A
Type of decices: J Addressable .� Conventional J Coded J Transmitter ❑ N/A
Type of smoke detector sensing technology: � Ionization �Photoelectric
5.22 Duct Smoke Detectors Number of duct smoke detectors:
Type of coveraae:
Type of devices: J Addressable J Con�entional .� Coded u Transmitter ❑ N/A
Type of smoke detector sensing technolo�-: J Ionization ❑ Photoelectric
5.2.3 Heat Detectors Number of heat detectors: l
Type of coverage: .�Complete area J Partial area ❑ Nonrequired partial area ❑ N/A
Ty-pe of devices: J Addressable �(Conventional J Coded u Transmitter �.7 N/A
52.4 Sprinkler R%aterflow Detectors IV'umber of waterflow detectors:
Type of devices .� Addressable =1 Conventional ❑ Coded J Trancmitter J N/A
52.5 Alarm Verification Number of decices subject to alarm verification:
Alarm verification on this system is: J Enabled ,2�Disabled ❑ Set for seconds
OO 2007 National Fire Protection Association NFPA 72(p.2 of 5)
FTGURE 4.5.2.1 Continued
^ COPYRIGHT 2007 NFPA,REPRODUCED WITH PERMISSION.
„L�e 2007 Edition
FU\DA:\IENT.�L.S OF FIRE AL.�P.:1i SISTEDIS 72-35
6. SUPERVISORY SIGNAL-INITIATING DEVICES AND CIRCUITS
6.1 Sprinkler System Number of valve supervisor�s�vitches: —
Type of de�-ices ❑ Addressable u Conventional ❑ Coded ❑ Transmitter ❑ N/A
6.2 Fire Pump ;
Type of fire pump: ❑ Electric ❑ Diesel
Type of fire pump supervisory de��ices: ❑ Addressable .� Conventional J Coded J Transmitter J N/A
Fire Pump Functions Supervised
=1 Fire pump power ❑ Fire pump runnino J Fire pump phase reversal � Selector switch not in auto
J Engine or control panel trouble J Low fuel
Other:
6.3 Engine-Driven Generator
Type of generator supervisory de�-ices: J Addressable :I Conventional _1 Coded u Transmitter U N!A
❑ Engine or control panel trouble J Generator running :J Selector sw-itch not in auto =1 Low fuel
Other:
7. ANNUNCIATORS
7.1 Annunciator 1 �Local � Remote
Type: '.� Addressable J Directory =I Graphic J IV/A Location: ���� ���-'`�c'"�-�
7.2 Annunciator 2 � Local � Remote
Type: J Addressable =1 Directory u Graphic J N/A Location:
7.3 Annunciator 3 � Local ❑ Remote
Type: J Addressable =1 Directory J Graphic J :�/A Location:
8. ALARM NOTIFICATION DEViCES AND CIRCUITS
8.1 Emergency Voice Alarm Service
Number of single voice alarm channels: Number of multiple voice alarm channels
�V'umber of speakers: Number of speaker zones:
8.2 Telephone Jacks
Number of telephone jacks installed: Number of telephone handsets stored on site:
Type of telephone system installed: =l Electrically powered ❑ Sound powered �I N/A
8.3 Nonvoice Audible System
Characteristics of notifccation deaice circuits connected to this system(see NFPA 72, Table 6.51:
Quantity: � Style: � Class: �
�O 2007 National Fire Protection Association NFPA 72(p.3 of 5)
FIGURE 4.5.2.1 Continued
COPYRIGHT 2007 NFPA,REPRODUCED WITH PERMISSION.
2007 Edition �
• 72-36 \ATIO\AI.FIRE AL.��RNI CODE �
8. ALARM NOTIFICATION DEVICES AND CIRCUITS (continued)
-- -8:4-T�rpes-ar�d-l�a�t�#ies o��Vcaravoice-No#i€aca#aor�-AppAances I�stalled ----- — - —
Bells: With visual device: Horns: With��sual de�-ice: v
Chimes: V4ith��sual de��ice: Bells: With�zsual de��ice:
Visual devices w-ithout audible de�-ices: �y Other(describe):
9. EMERGENCY CONTROL FUNCTIONS ACTIVATED
❑ Hold-open door releasing devices ❑ Smoke management or smoke control '
❑ Door unlocking ❑ Elevator recall J Other
10. SYSTEM POWER SUPPLY
10.1 Primary Power �Q
Nominal voltage ���vl Amps
Overcurrent protection: Type �s le��e� Amps l �
Location(of primary supply panelboa d): - a/J�'r %v ��C�
Disconnectin g means location: �G�►-� �_�5 d eU-�-�f �� �F- ��
10.2 Secondary Power
Location: Ty�e: Nominal coltage: Current rating:
Number of standby batteries: � <4mp hour rating. 2_S� t�.�,�
Location of emergency generator:
Location of fuel storaae:
Calculated capacity of secondary power to drive the s�stem
In standby mode: �� �/' In alarm mode: ��F�`� .
11. RECORD OF SYSTEM INSTALLATION
Fill out after all install¢tio�a is complete and wirinba has been checked for opens,shorts,grou�zd faults, and improper
br¢nching, but before conducting operational acceptance tests.
The system has been installed in accordance wzth the follo��zng 1�'FPA standards:(Note any or all that applyJ
is'NFPA 72 �FPA 70,National Electrical Code,Article 760
:d��Manufacturer's published instructions J Other(please specify):
System deeiations from referenced NFPA standards:
Signed• � Printed name: ��'`'�4� o� Date: ^� '� ���-
Organization: f � c�•rY'feS -e r� Title:D�U�S' ..c 4c / Phone:S�� 'Y1-� ri%�'.2
12. RECORD OF SYSTEM OPERATION
All operational features and functions of this system were tested by or in the presence of the signer shown below,on
the date shown below,and were found to be operating properly in accordance with the requirements of:
�NFPA 72 ,�FPA i0,National Electrical Code,Article 760
�Manufacturer's published instructions ❑ Other(please specify):
J Documentation in accordance u�ith Inspection and Testing Form(Figure 10.6.�.3)is attached
Signed: Printed name/���rL ��'^�e�� Date:
Organization•N/J f'-od]`'.�S� �� Title:����i�`s-� -���P r Phone:�-Z� ' Yl G '�/°-2
OO 2007 National Fire Protection Association NFPA 72(p.4 of 5)
FTGURE 4.5.2.1 Continued
COPYRIGHT 2007 NFPA,REPRODUCED WITH PERMISSION.
,� 2007 Edition
. FU\D.��1E\TAL.S OF FTREAI��R!\I Sl'STE�1S 72-37
13. CERTIFICATIONS AND APPROVALS
- - 3:�Sy-sfem 1ns a ia�ion C�r�o� ---------------------- ------------------ '
This system as specified herein has been installed and tested accordinp to all NFPA standards cited herein.
Signed: Printed name�/ 'G"� �� Date: s� '� ',Z
Organization: T � Title: Phone:f'���` ��6 I��
13.2 System Service Contractor
This system as specified herein has been installed and tested according to all NFPA standards cited herein.
Signedf/< ��� Printed name: �( c� r- Date: .z -� �- �2-
Organization: /V`� �1 r���S �c�ur�.�+` Title: �,/- .' � ,r Phone:ct2c�- `(�z6-r/g2
13.3 Central Station
This system as specified herein w�ll be monitored according to all NFPA standards cited herein.
Signed• "�"� Printed name:�> L�J�--�/���o�� Date:� �.� 'I Z
Organization:�� � e�c,�J<<f Title: ��-��-��' Phone:��� `Yz� �-�'i/e2
13.4 Property Representative
I accept this system as having been installed and tested to its specifications and all NFPA standards cited herein.
�
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' z� , �r� �,� ��,��: � i��`��r"�r �►���1��
Sia ed:,��J� �� !/� '� Printed name:. � �� ( Date:
Organization:�� ' C�/� ; ���/�lG�% Title: 1!I� f C��{ Phone:�i�.� �:��7 `��L/
1�. /'',i' /�,,,li��-t- �
(.t�U l.G
13.5 Authority Having Jurisdiciion
I have witnessed a satisfactory-acceptance test of this system and find it to be installed and operating properly
in accordance wzth its approved plans and specifications,its approved sequence of operations,and�-ith all NF'PA
standards cited herein.
Sia ed: Printed name: Dat.e:
Organization: Title: Phone:
OO 2007 National Fire Protection Association NFPA 72(p.5 of 5)
FIGURE 4.5.2.1 Continued
COPYRIGHT 2007 NFPA,REPRODUCED WITH PERMISSION.
2007 Edition �